Major trends, including the marriage of medicine and technology, are revolutionizing health care even as US politicians struggle to find a path forward on ensuring access and affordability for all Americans.

How and whether Congress repeals and replaces Obamacare will shape health care in America, but there are other trends that may have as much or more impact.

Frank Baitman and Kenneth Karpay, who are involved in health care technology, identify “three immutable trends” in the US health care system that will march on regardless of what Congress does or doesn’t do. The trends are the aging of America, the marriage of technology and medicine and new life science discoveries that are bursting from research laboratories.

“Taken together,” Baitman and Karpay write in the Harvard Business Review, “these three trends will drive dramatic changes in health care, regardless of government policies. We see several areas where patients and care providers, as well as entrepreneurs and investors, will likely benefit.”

While politicians bicker over health insurance strategy, health care officials and investors are focusing on patient engagement, which Baitman and Karpay say is linked to better heath care outcomes. “Technology plays a crucial role in promoting engagement, in part by customizing medical information for each patient and [using] digital platforms that promote health and help patients understand their medical conditions and options for treatment and prevention.” The authors say there were 296 digital health start-ups in 2016 and they expect $4-$5 billion will be invested annually in this evolving health care sector.

One way to promote more affordable health care, they say, is to bring medicine to patients, especially older people, instead of patients to hospitals or clinics. The savings goes far beyond avoided travel costs and risks. “Today’s telemedicine technology enables practitioners to scale their services, seeing more patients in less time and it embeds analytics that can help focus clinicians’ time on the cases where they have the greatest effect,” according to Baitman and Karpay. Patients benefit by more frequent contact with their health care providers, which can improve coordination on ongoing treatment of chronic conditions. The authors note there are now 3,000 apps to aid in managing diabetes.

The market is adapting to a expanding aging population by offering aids to enable older people to live independently or in facilities that allow semi-independent living situations.

The growing availability of personal health data and declining cost of integrating those massive health data sets is galvanizing medical research into what might be called personal medicine. “The pipeline for new drugs is bursting and new devices and tools in the rapidly emerging digital health space will come to market more quickly,” Baitman and Karpay say.

Even though the explosion of new drugs and devices will open up new treatments, it also will create a conundrum for medical providers who must keep up with new options and health care payer who need to figure out affordable strategies to pay for them. Baitman and Karpay predict the “current payer strategy of negotiating favorable pricing” will be seriously challenged.

The question marks on Capitol Hill surrounding a replacement for Obamacare are unlikely to alter these trends, Baitman and Karpay insist. "Uncertainty surrounding the health care bill shouldn’t have a material effect on the success of various solutions. Indeed, with the current government gridlock, the rapid development of and growing demand for new health care technologies may help policymakers chart the course forward.”